The invention relates to patient care equipment and in particular to equipment for the care and transport of incontinent patients. Specifically, it relates to a transport facility that may be used as a wheel chair and which may be converted to a bed-like facility that is similar to a mobile stretcher. The transport facility is particularly useful for incontinent patients, especially those patients who also have a difficult time moving because they lack the use of their limbs. The portable transport and care vehicle facilitates both transport and care by a single attendant.
The portable transport and care vehicle for patients may also be used as a temporary rest facility for the patients using it as a wheel chair, because of the easy conversion from a wheel chair to a bed-like facility, which can be done by a single attendant without the need for removing the patient from the wheel chair.
The patient transport and care vehicle is particularly useful in conjunction with a portable gravity bath facility disclosed in a copending application, Ser. No. 329,447 filed Dec. 10, 1981.
Incontinence care and the problems associated with the management of incontinence among wheelchair dependent and bed-ridden patients at home, in hospitals and in nursing homes, have imposed a tremendous burden upon society, namely the providers and recipients of care and their families. This has occurred primarily becasue of a lack of adequate and appropriate means to deliver care, and from an ever increasing number of the nation's elderly, age 65 years and older, with dementia secondary to primary degenerative dementia.
Since the nineteen sixties, research on the problems of incontinence expanded the use of surgical procedure, indwelling and external catheters, and for a time bowel and bladder training programs in the treatment and management of urinary and fecal incontinence with varying degrees of success. Development of pneumonias and formation of decubiti necessitating, long hospial stay, due to urinary incontinence have been successfully reduced and curtailed to some extent. Success with fecal incontinence, however, with its devastating impact upon patients, relatives, and providers of care has been slower and more difficult to achieve, because of ongoing research in this area and the inability of providers to meet the demand for care by larger and larger numbers of patients with greater dependencies, more severe physical disabilities, and intellectual impairment due to cerebral infarcts.
The high incidence of multi-infarct dementia in individuals over 65 in our society, coupled with an increase in other forms of dementia, such as alcoholic, post-head trauma, post-anoxia, and those both undiagnosed and related to specific neurological diseases, such as Huntington's Chorea and Parkinson's disease, has significantly increased multi-infarct dementias among patient populations in the nation's 25,000 nursing homes, its 7,015 registered and 214 unregistered hospitals.
Research on wheelchairs has progressed very slowly over the last one hundred years, despite increasing dependency of larger numbers of housebound and institutionalized patients who depend upon the use of wheelchairs. Until relatively recently, many of the nation's 250,000 to 500,000 wheelchair dependent patients saw research efforts directed to make manual and powered chairs more easy to operate through radically different wheel designs and attachment of microcomputers. Glaser of Wright State University in Dayton has focused attention on energy expenditure for mobility and efficiency of mobility. Jaffe, Koogle, and La in the Veteran Administration's Department of Rehabilitative Engineering have concentrated on mobility efficiency. Little research has been directed toward comfortability and care delivery, two very important reasons for institutionalization of increasing numbers of patients with incontinence who under different circumstances can be successfully cared for at home.
This invention is developed to obviate the necessity for institutionalization of certain categories of wheelchair dependent incontinent patients and to expand the scope and utilization of wheelchair and bed-type equipment as care delivery items.
In the care of the aged, and particularly the care of incontinent aged and the aged who have suffered a stroke or other injury that deprives them of the use of some or all of their limbs, problems arise for both the patient and the attendant. As a matter of fact, such problems also exist for many patients who are not aged. This invention provides a means for overcoming the problems encountered.
While some improvements have been made in transport equipment for patients, in general all makes of wheel chairs and mobile stretchers have been designed to enhance mobility of the patients and to aid in their transportation. Little or no emphasis has been devoted to improving the equipment to make it more care efficient. This is particularly true regarding transport equipment for bed-ridden patients, especially, the incontinent patients.
Regarding the incontinent patients, the prior art has provided no improvements to permit the cleaning of wheel chair-dependent patients to be carried out with ease and some degree of efficiency. In the prior art it has been necessary to transfer patients from a wheel chair to a bed to clean them. The present invention overcomes these problems.
Incontinent patients, including those who have little or no use of their limbs, experience feelings of a sense of neglect, indignity, and humility because of their conditions of urinary and fecal incontinence. This condition exists in hospitals, nursing homes, and in private homes. The conditions are made worse by the reactions of employee attendants and relatives, perhaps unintentional, to the conditions which exist because of poorly designed transport equipment or the manner in which it must be used. The present invention provides a means for overcoming these conditions.
Although there is a tremendous impact upon the lives of patients, attendants, and relatives by the cited conditions, attempts to deal with the problem of incontinence, primarily fecal incontinence have been feeble and the focus has been misdirected. The result has been that the relationship between patients and their relatives is psychologically depressing, esthetically repulsive, and socially demoralizing.
The problem of total dependence of bed-ridden, or bed to wheel chair, patients associated with incontinence is a severe burden and almost impossible to deal with where a single attendant is involved. Patient neglect and abuse normally follow.
Federal and state regulations in most cases mandate that a minimum of two hours of care be provided to patients in skilled nursing facilities. In many cases the problem of incontinence makes such standards unattainable.
In the prior art, the cleaning of a soiled wheel chair patient still requires the patient to be moved to a bed for the cleaning. When the patient is not only incontinent, but also does not have full use of the limbs, the problem is magnified. This transfer from a wheel chair to a bed is not only difficult, but the soiled condition is made worse by the transfer. The present invention provides a means for minimizing the problems encountered as no transfer from the wheel chair is required and the soiled condition of the patient is not made worse during the use of the patient transport and care vehicle.
In the present invention the patient is relieved of the depressing, self-imposing isolation, and other indignities that incontinent patients feel. The attendants, professional or semi-professional, and relatives, providing nursing care have an improved means of providing the care. The patient transport and care vehicle enables even the non-skilled in the art of caring for the sick, particularly the incontinent, to provide proper care with a minimum of difficulty.
The patient transport and care vehicle is convertible from a wheel chair configuration to a mobile stretcher or bed-like configuration and back again to a wheel chair. The vehicle can be moved easily by a single attendant and can be converted as aforesaid by a single attendant, thus improving the availability of patient care. The conversion can be made without removing the patient from the vehicle when it is in the wheel chair mode or when making the conversion from the bed or stretcher mode to the wheel chair configuration.
Thus, a soiled incontinent patient can be cleaned by a single attendant without placing an added burden on the patient or the attendant. The cleaning is further facilitated when performed in conjunction with the aforementioned portable gravity bath. Such use minimizes the handling of human waste by an attendant.
It is, therefore, an object of this invention to provide a combination transport and care vehicle for patients.
It is another object of this invention to provide a transport and care vehicle to facilitate the handling and cleaning of incontinent patients.
It is also an object of this invention to provide a transport and care vehicle to facilitate the handling and care of patients that do not have full use of their limbs.
It is yet another object of this invention to provide a transport and care vehicle that can be used in a wheel chair configuration.
It is yet still another object of this invention to provide a transport and care vehicle that can be converted to a wheel chair or a mobile stretcher means without removing the patient.
It is also another object of this invention to provide a transport and care vehicle that can be utilized and converted for a plurality of uses by a single attendant.
Another object of this invention is to provide a transport and care vehicle to obviate the necessity for institutionalization of dependent and incontinent patients in nursing homes and hospitals due to incontinence because of lack of the appropriate equipment.
Still another object of this invention is to provide a patient transport and care vehicle which will reduce the cost of hospital and nursing home care due to institutionalization associated with incontinence and/or disability of patients.
Further objects and advantages of the invention will become more apparent in light of the following description of the preferred embodiments.